人工鼻联合密闭式吸痰对人工气道湿化的效果观察  

Artificial humidified effects for airway by heat / moisture exchanger combined dosed endotracheal suctioning

作　　者：林育群[1] 蔡毅峰[1] 吴灿红[1] 

机构地区：[1]潮州市中心医院ICU,广东省潮州521000

出　　处：《中国基层医药》2011年第8期1017-1019,共3页Chinese Journal of Primary Medicine and Pharmacy

基　　金：广东省潮州市2009年度科技引导计划立项项目（2009S16）

摘　　要：目的观察人工鼻联合密闭式吸痰对建立人工气道机械通气患者湿化效果的影响。方法将人住ICU机械通气超过48h的患者1J4例按随机数字表法分为观察组（人工鼻联合密闭式吸痰组）59例和对照组（开放性吸痰管联合加温加湿器组）55例，对两组人工气道湿化的效果、应用人工气道时间、应用机械通气时间、呼吸机相关性肺炎（VAP）的发生率、住ICU的时间、住院病死率等方面进行比较。结果观察组患者痰液湿化效果好的病例多于对照组，导管痰痂病例少于对照组；应用人工气道时间两组病例比较无差异；观察组在应用机械通气时间和住ICU的时间上均少于对照组，观察组VAP发生率低于对照组；病死率两组病例比较无差异；观察组无湿化意外出现，对照组发生呛水8例。结论机械通气患者使用人工鼻联合密闭式吸痰进行气道管理，能够满足加热加湿吸入气体的要求，有利于改善气道湿化效果，且能降低VAP发生率，缩短机械通气时间。Objective To explore humidifying effects for artificial airway of mechanically ventilated patients by heat/moisture exchanger（HME） combined closed endotracheal suetioning（CS）. Methods A total of 114 patients who had mechanical ventilation for at least 48h were randomly divided into two groups with 59 cases in experimental grooup and 55 cases in control group. HME combined CS were used in the experimental group, heated humidifier combined open endotraeheal suetioning were used in the control group. The effect of humidification, the reserved time of artificial airway, the time on mechanical ventilation, the time of stay in ICU, the incidence of ventilator-associated pneumonia（VAP） and the mortality rate between the two groups were compared. Results Significant differences were found in the effect of humidification between the experimental group and the control group, more cases found in sufficiency of humidification or excessive humidification and airway spasm in the control group, however,less time on mechanical ventilation and stay in ICU in the experimental group. The incidence of VAP in the control group was significantly higher than that in the experimental group. There were no significant differences existed in the reserved time of artificial airway and the mortality rate between the two groups. There were no aceident of humidification occurred in the experimental group,while 8 eases complicated with choking with water in the control group. Conclusion HME combined CS,used in mechanically ventilated patients, could help to improve the effects of airway humidification and reduce the incidence of VAP, also shorten the duration of mechanical ventilation.

关 键 词：机械通气 人工鼻 密闭式吸痰 气道管理 湿化 

分 类 号：R47[医药卫生—护理学]